The Centers for Disease Control and Prevention report 86 million American adults have prediabetes, and of those, as many as a third will become diabetics within five years.
Beginning January 1, 2015, virtually all private insurers must cover services — with no copay — that help people with elevated blood sugar levels change their diets and increase their physical activity.
Health officials hope the change in coverage will drive down diabetes rates.
At the same time, make no mistake: Entrepreneurs “feel the commercial winds blowing,” said Omada Chief Commercial Officer Mike Payne.
Omada has designed an online program for prediabetics to eat better, lose weight and become more active. Omada is one of about 700 groups that are CDC-certified which offer intensive behavioral counseling. That includes the dude working out of a church as a health coach to Weight Watchers to the YMCA.
Payne estimated this is as much as a $150 million dollar industry now, which could more than triple by 2017.
“I think what you are seeing is organizations like Omada and the YMCA, they are getting to a scale and an operational sophistication that you need to deliver programs like this to tens of thousands, hundreds of thousands, millions of people,” he said.
The CDC’s Ann Albright hopes making these services essentially free cuts down on the number of diabetics.
According to the American Diabetes Association, one of every five healthcare dollars is spent treating the condition.
“We are on this ridiculous trajectory of moving from prediabetes to diabetes,” she said. “Honestly we can’t sustain this kind of growth.”
The potential savings from preventing cases of Type 2 diabetes could be staggering, but the YMCA’s Matt Longjohn said only 10 percent of people with prediabetes even know they are at risk.
“What percentage of those people are actually motivated to make behavior change while they are happily living their lives?” he said.
Longjohn acknowledges that on paper, the market for these services is enormous. But he wonders how many of us are really ready to make the necessary changes.